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See the profile on medical dosimetrists in the Occupational Outlook Handbook.
We design radiation treatment plans for cancer patients. These treatment plans direct the radiation machine to deliver electromagnetic waves to a tumor while sparing as much of the healthy tissue as possible.
First, the patient consults with a radiation oncologist. Then, they undergo a CT scan. I take that scan and import it into our treatment planning software with other diagnostic scans so the doctor can draw the tumor. I contour, or draw, organs adjacent to the tumor so we can monitor each organ’s radiation dose throughout treatment.
Next, the radiation oncologist gives me a planning directive. This is what I consider the “recipe” for the treatment plan. It tells me the treatment modality (method) and the prescribed radiation dose based on the patient’s tumor type, stage, and location. This helps guide me in coming up with the best plan possible, one that includes the beam angles and beam shape, to deliver the dose of radiation to the tumor.
Once I come up with a plan for a patient, I review it with the radiation oncologist. After the radiation oncologist approves the treatment plan, I send the plan to the machine by transferring the beam parameters and data.
Before treatment is delivered to the patient, the treatment plan undergoes quality assurance testing. It’s like a dry run before the patient gets on the table to be treated. This testing is a way to make sure that the treatment plan is safe and accurately delivered on the machine.
After that, the patient receives treatment. Radiation therapists, radiation oncologists, medical physicists, dosimetrists—we all closely work together as members of the radiation oncology team to ensure that the plan is delivered properly and the patient receives the best care.
I might assist with quality assurance testing on the machine and resolve errors that may arise. I might help with simulating (positioning) the patient for delivering treatment.
Additionally, there’s a lot of documentation that needs to be done during the entire treatment process, including archiving patient files and assisting with chart checks.
I always knew that I wanted to work in healthcare. My dad is a physician, and I enjoy serving and helping people. In college, I took some physics and science prerequisite courses and then started the dosimetry program at the University of Arkansas. I graduated with a bachelor's degree in medical dosimetry. Right out of the dosimetry program, I sat for the Medical Dosimetrist Certification Board exam.
While studying for the exam, I worked part-time as a junior dosimetrist at the University of Arkansas. After passing the exam, I got a full-time job at a cancer center, first in Mississippi and then in Tennessee. Now I work for a group of dosimetrists and physicists who are contracted by a hospital.
A more traditional route of dosimetry is to go to radiation therapy school (to earn an associate’s or bachelor’s degree) and then go to medical dosimetry school. To sit for the national board exam, you have to graduate from an accredited program. Depending on the program you choose, you can earn a certificate or a bachelor's or master’s degree in medical dosimetry. Some programs require applicants to be a radiation therapist (which requires licensing or certification along with a degree).
You need to be knowledgeable in areas like anatomy, physics, and mathematics. You also must have good communication and interpersonal skills, good organizational skills, and the ability to multitask. And you need to demonstrate a high level of critical thinking and problem solving.
It’s good to be tech savvy and have a willingness to embrace new technology, because the field is constantly evolving.
Lack of time! It feels like we’re always working against the clock in maintaining day-to-day tasks and keeping up with patient load. Patient treatment plans can be challenging and time consuming, and complications can occur with treatment planning. It’s our job to find solutions to problems that arise so we can provide the best treatment for each patient.
I like that I’m challenged every day. I love helping people and serving, caring, and advocating for patients. It’s very satisfying to be a part of survivorship for cancer patients. Having the opportunity to help somebody in their cancer journey can be very rewarding.
I like that I’m part of a team that’s making a difference.
Dustin Riles, "Medical dosimetrist," Career Outlook, U.S. Bureau of Labor Statistics, November 2023.